Is it possible to become an FP after working as an internist?

[ruffryder]

Hi all,

 

This question has in all likelihood been asked before, but I cannot find the answer after quickly sifting through this forum. Does anyone know if you can work as an internist, and then become a family doctor somewhere down the road? Does this require additional training?

 

Thanks

[BigM]

Hi all,

 

This question has in all likelihood been asked before, but I cannot find the answer after quickly sifting through this forum. Does anyone know if you can work as an internist, and then become a family doctor somewhere down the road? Does this require additional training?

 

Thanks

 

Someone correct me if I'm wrong, but you can only do family medicine if you do your residence in family. Specialists cannot operate from a family medicine clinic or walk-in clinic.

[ruffryder]

Ok thanks guys. That is unfortunate... Our health care system just seems so rigid and works against the very people who are the pillars of the system.

[Lactic Folly]

You could, however, re-enter residency in family medicine to retrain.

[Satsuma]

You could consider doing FP and then work as a hospitalist, to get a bit of both worlds.

[thebouque]

Ok thanks guys. That is unfortunate... Our health care system just seems so rigid and works against the very people who are the pillars of the system.

 

No it's just normal that an internist cannot do the job of a family doctor. He certainly isn't fit to treat children, do ob gyn, minor surgeries, psych etc etc that are very common in family medicine.

[leviathan]

No it's just normal that an internist cannot do the job of a family doctor. He certainly isn't fit to treat children, do ob gyn, minor surgeries, psych etc etc that are very common in family medicine.

Exactly..although I think it's possible for internists to work strictly in outpatient offices but I guess patients wouldn't be able to come in without a referral.

[Lactic Folly]

Internists have more of a role in primary care for adults in the US.

[ruffryder]

No it's just normal that an internist cannot do the job of a family doctor. He certainly isn't fit to treat children, do ob gyn, minor surgeries, psych etc etc that are very common in family medicine.

 

Good point.. I didn't think about all the things that a family doctor is trained to do that an internist is not. Does anyone know how difficult it is to be accepted into a family medicine program after working as an internist then?

[Lactic Folly]

I think the main requirement would be to find someone to fund your residency training (e.g. government re-entry programs, return-of-service contracts from underserviced communities).

[olecranon]

whyyyyyy would you want to do that. if you think you might want to do family one day why not just do family? if you love internal enough to do a residency in it presumably you would assume all the responsibilities and call and lifestyle that comes with it in the first place or go into rheumatology. If you do family medicine right, there is immense intellectual challenge and reward if that is what worries you. If you get sick of chronic care, do an R3 and do emerg. If you don't want to be labelled as "just" a family doctor...well sadly the more people who give in to this crap the more perpetual this notion gets. Its so nice when i hear some of the smartest people in my class who confidently say they want family medicine.

[rmorelan]

whyyyyyy would you want to do that. if you think you might want to do family one day why not just do family? if you love internal enough to do a residency in it presumably you would assume all the responsibilities and call and lifestyle that comes with it in the first place or go into rheumatology. If you do family medicine right, there is immense intellectual challenge and reward if that is what worries you. If you get sick of chronic care, do an R3 and do emerg. If you don't want to be labelled as "just" a family doctor...well sadly the more people who give in to this crap the more perpetual this notion gets. Its so nice when i hear some of the smartest people in my class who confidently say they want family medicine.

 

The lack of transfering kind of annoys me as well. There is every chance that I will at some point retrain as a family doctor - partially because it is something new and partially because some of the fields I am considering have rigid limits and semi forced retirement.

 

The old intern system made this a lot easier and gave us more time to figure out what would be the best field. Things feel more squeezed now.

[apache]

General internists really should be allowed to work in walk in FM though, who are we kidding.

 

Nope. The CCFP feels that it really needs to set itself apart, so those who are not residency certified in FP cannot practice FP. And people wonder why there is an FP shortage...

[rmorelan]

General internists really should be allowed to work in walk in FM though, who are we kidding.

 

They are almost upgraded family doctors in a sense. Sounds like they have a pretty interesting practise as well since they get to deal with a much wider range of things than the more specialized internal medicine guys.

[thebouque]

General internists really should be allowed to work in walk in FM though, who are we kidding.

 

But GIM physicians have their own outpatient clinics. Why would they work in a walk in FM clinic? Most of the patients they see in their outpatient service have been referred by their FM doc. And also, as I've stated previously, there's the issue of dealing with gyn, peds, psych etc in a walk in FM clinic.

[olecranon]

But GIM physicians have their own outpatient clinics. Why would they work in a walk in FM clinic? Most of the patients they see in their outpatient service have been referred by their FM doc. And also, as I've stated previously, there's the issue of dealing with gyn, peds, psych etc in a walk in FM clinic.

 

yeah i hear this a lot too (that GIM docs have their own clinics) but never in my life have i heard of any FP referring to GIM...so unless they are follow ups from the hospital i have no idea where they get their patients...

[Ollie]

yeah i hear this a lot too (that GIM docs have their own clinics) but never in my life have i heard of any FP referring to GIM...so unless they are follow ups from the hospital i have no idea where they get their patients...

 

I definitely refer to GIM, although not as often as to subspecialists. Typical referrals would be for something like weight loss or fatigue after I haven't found anything in my work up. I will also refer for some help with patients with multiple comorbidities (CAD, DM, CKD). It's really helpful to have a general internist look at the whole picture rather than sending someone to cardio, endo and nephro.

[Satsuma]

yeah i hear this a lot too (that GIM docs have their own clinics) but never in my life have i heard of any FP referring to GIM...so unless they are follow ups from the hospital i have no idea where they get their patients...

 

We refer from the ER quite alot. Pts will be seen in a matter of days and it is a great service that allows for defering admissions - for pts that don`t really need to be admitted, but wouldn`t be able to be sent home without proper and timely follow-up. All centres may not have a service set up like this, but it is a good one I think!

[rmorelan]

I definitely refer to GIM, although not as often as to subspecialists. Typical referrals would be for something like weight loss or fatigue after I haven't found anything in my work up. I will also refer for some help with patients with multiple comorbidities (CAD, DM, CKD). It's really helpful to have a general internist look at the whole picture rather than sending someone to cardio, endo and nephro.

 

I thought general internalists worked a lot in the mid size communities and smaller(?) At least that was the impression I got from the few I meet during one of our outreach style training weeks. If you have a person with mulitple chronic illnesses (ie a lot of people) that seems somehow logical to me. When need the GIMs there referred to more specialized docs.

[thebouque]

Also don't forget that there are some (rare) fields that are the exclusive expertise of GIM such as obstetrical medicine.

[Lactic Folly]

In the USA GIMs often practice at PCP as well as internist in a hospital. I don't know if that is a good thing or not. I guess it would make sense for those who have chronic illnesses like CKD, CHF, autoimmune disease, rare illnesses, etc..

 

Indeed, the American College of Physicians (=Internal Medicine) bill themselves as "Doctors for Adults."

http://www.acponline.org/patients_families/about_internal_medicine/

[rmorelan]

In the USA GIMs often practice at PCP as well as internist in a hospital. I don't know if that is a good thing or not. I guess it would make sense for those who have chronic illnesses like CKD, CHF, autoimmune disease, rare illnesses, etc..

 

That explains the show scrubs a bit more and it really does kind of make sense to me. You would think a GIM would be quite useful in critical care as well.